scholarly journals Polypharmacy and lack of joy predict physical frailty among northern Japanese community-dwellers from the ORANGE cohort study

2020 ◽  
Author(s):  
Yu Kume ◽  
Tomoko Takahashi ◽  
Yuki Itakura ◽  
Sangyoon Lee ◽  
Hyuma Makizako ◽  
...  
Keyword(s):  
Older Adults ◽  
Rural Areas ◽  
Assessment Tool ◽  
Frailty Index ◽  
Limited Information ◽  
Physical Frailty ◽  
Cognitive Domains ◽  
Frailty Status ◽  
Critical Issues ◽  
Community Dwellers

Abstract Background: A gradually increasing prevalence of frailty is recognized in the super-aging society that Japan faces, and early detection and intervention of frailty in community-dwellers are critical issues to prevent frailty. Although previous studies have well documented the characteristics of physical disability, there is limited information on frail state differences among older adults in Japanese rural areas. The aim of this study was to clarify the association and predictors of frail status in northen Japan community-dwellers aged 65 or more.Methods: The investigation was conducted from 2018 to 2020. After obtaining informed consent from each participant, assessments and outcomes were evaluated according to the ORANGE protocol. Participants were recruited from Akita community-dwellers in northern Japan. We applied the frailty index of Gerontology - the Study of Geriatric Syndromes (NCGG-SGS) to classify frailty status, collecting data of demographics and psycho-social status using the Kihon checklist and cognitive domains including the National Center for Geriatrics and Gerontology Functional Assessment Tool (NCGG-FAT).Results: Our subjects included 313 older adults divided into 138 robust, 163 prefrail and 12 frail. For statistical analysis, physical frailty and cognitive decline were related, and polypharmacy and a lack of joy in daily life were the main predictors of frail status.Conclusions: Reducing medications and finding fun in your life are important to prevent frailty.

Polypharmacy and Lack of Joy Are Related to Physical Frailty among Northern Japanese Community-Dwellers from the ORANGE Cohort Study

Gerontology ◽  
2021 ◽  
pp. 1-10
Author(s):  
Yu Kume ◽  
Tomoko Takahashi ◽  
Yuki Itakura ◽  
Sangyoon Lee ◽  
Hyuma Makizako ◽  
...  
Keyword(s):  
Older Adults ◽  
Rural Areas ◽  
Assessment Tool ◽  
Frailty Index ◽  
Limited Information ◽  
Physical Frailty ◽  
Cross Sectional ◽  
Explanatory Variables ◽  
Frailty Status ◽  
Community Dwellers

<b><i>Introduction:</i></b> A prevalence of frailty is gradually increasing with the progress of aging in Japan, and critical challenges regarding early diagnosis and prevention of frailty were necessary in community. Although previous studies have well documented the characteristics of physical disability, there is limited information on frail state differences among older adults in Japanese rural areas. The aim of our cross-sectional observational study was to clarify the association of frail status in northern Japanese community-dwellers aged 65 or more. <b><i>Methods:</i></b> 345 participants were recruited from 2018 to 2020, and after getting informed consent from each participant, assessments and outcomes were evaluated according to the ORANGE protocol. We applied the frailty index of Gerontology-the Study of Geriatric Syndromes (NCGG-SGS) to classify frailty status by collecting data of demographics and psychosocial status using the Kihon checklist (KCL) and cognitive domains used by the National Center for Geriatrics and Gerontology-Functional Assessment Tool (NCGG-FAT). <b><i>Results:</i></b> Our subjects included 313 older adults divided into 138 robust, 163 prefrail, and 12 frail. For statistical analysis, we found that the frail group had a lower educational duration, worsened KCL items, lower cognitive functions, and a tendency toward depression compared to the other groups. Moreover, physical frailty and cognitive decline were related, and polypharmacy and a lack of joy in daily life were explanatory variables of frail status. <b><i>Conclusions:</i></b> We suggest that KCL is important for frail discrimination, and in order to prevent physical frailty, our community should take care of not only exercise and nutrition but also cognitive functioning and depressive tendencies. In particular, polypharmacy and the presence of fun in your life are possible to be related to frailty.

scholarly journals OPERATIONALIZING THE FRAILTY INDEX BASED ON WEARABLE SENSOR TO ASSESS FUNCTIONAL PERFORMANCE IN OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S680-S680
Author(s):  
Hung Nguyen ◽  
Jacqueline Yang ◽  
Mohsen Zahiri ◽  
Bijan Najafi
Keyword(s):  
Older Adults ◽  
Grip Strength ◽  
Assessment Tool ◽  
Functional Performance ◽  
Frailty Index ◽  
Activity Level ◽  
Wearable Sensor ◽  
Frailty Status ◽  
Frailty Assessment ◽  
Flexion And Extension

Abstract Frailty status is a well-known predictor of adverse health outcomes and functional performance. An assessment tool based on a wearable sensor was developed to quickly assess frailty using an upper extremity flexion and extension test. However, the current tool has relied on conventional frailty assessment to classify the frailty status of the participant. The aim of this study is to operationalize the frailty index based on wearable sensor to classify frailty status of older adults. 104 older adults were recruited for the study (age=78.6 ±9.7 years old). Participants were asked to perform a quick 20-second upper flexion and extension task while wearing a gyroscope on the wrist. A sensor-based frailty index (FI) was derived using parameters extracted from the sensor. Participants were also assessed using the Fried Phenotype Criteria (FC) and were classified into three groups: robust, pre-frail, and frail. Mean-shift clustering algorithm was used to operationalize the FI by identifying the cut-off point for each group. Grip strength and physical activity level were used as functional outcome measures. Regression analysis (r) was used to compare the correlation of the FC and FI with the identified metrics. Bivariate analysis show that grip strength was highly associated with the sensor-based frailty classification (r=-0.547) and FC (r =-0.503). The sensor-based classification was significantly associated with walking activity (r=-0.355). The results showed that the sensor-based frailty assessment tool could be used to quickly classify frailty status in older adults and eliminated the need for subjective and time-consuming evaluation.

scholarly journals A Clinical Bridge between Family Caregivers and Older Adults: The Contribution of Patients’ Frailty and Optimism on Caregiver Burden

2021 ◽  
Vol 18 (7) ◽  
pp. 3406
Author(s):  
Alberto Sardella ◽  
Vittorio Lenzo ◽  
Angela Alibrandi ◽  
Antonino Catalano ◽  
Francesco Corica ◽  
...  
Keyword(s):  
Older Adults ◽  
Family Caregivers ◽  
Caregiver Burden ◽  
Frailty Index ◽  
Dispositional Optimism ◽  
Related Factors ◽  
Life Orientation Test ◽  
Life Orientation ◽  
Frailty Status ◽  
Personal Time

The association between caregiver burden and the physical frailty of older adults has been the object of previous studies. The contribution of patients’ dispositional optimism on caregiver burden is a poorly investigated topic. The present study aimed at investigating whether older adults’ multidimensional frailty and optimism might contribute to the burden of their family caregivers. The Caregiver Burden Inventory was used to measure the care-related burden of caregivers. The multidimensional frailty status of each patient was evaluated by calculating a frailty index, and the revised Life Orientation Test was used to evaluate patients’ dispositional optimism. The study involved eighty family caregivers (mean age 64.28 ± 8.6) and eighty older patients (mean age 80.45 ± 7.13). Our results showed that higher frailty status and lower levels of optimism among patients were significantly associated with higher levels of overall burden and higher burden related to the restriction of personal time among caregivers. Patients’ frailty was additionally associated with caregivers’ greater feelings of failure, physical stress, role conflicts, and embarrassment. Understanding the close connection between patient-related factors and the burden of caregivers appears to be an actual challenge with significant clinical, social, and public health implications.

Prospective Associations of Physical Frailty With Future Falls and Fear of Falling: A 48-Month Cohort Study

2021 ◽  
Author(s):  
K Makino ◽  
S Lee ◽  
S Bae ◽  
I Chiba ◽  
K Harada ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Fear Of Falling ◽  
Community Dwelling ◽  
Cardiovascular Health Study ◽  
Physical Frailty ◽  
Frailty Status ◽  
Community Dwelling Older Adults ◽  
The Relationship

Abstract Objective The present study aimed to examine the prospective associations of physical frailty with future falls and fear of falling (FOF) among community-dwelling older adults. Methods A prospective cohort study with a 48-month follow-up was conducted in a Japanese community. Participants were 2469 community-dwelling older adults aged 65 years or older who completed baseline and follow-up assessments at intervals of 48±2 months. Primary outcomes were recent falls (defined as at least one fall within the past year) and FOF (determined by response to “Are you afraid of falling?”) at follow-up survey. Physical frailty, operationalized by the frailty phenotype (slowness, weakness, exhaustion, weight loss, and low activity) based on the criteria of the Japanese version of the Cardiovascular Health Study (J-CHS), was also assessed as a predictor of future falls and FOF. Results Multivariate logistic regression showed that pre-frailty or frailty increase the risk of not only future falls (OR: 1.57; 95%CI = 1.20-2.05) but also FOF (OR: 1.33; 95%CI = 1.05-1.69). In addition, the relationship between baseline frailty status and future falls remained significant after adjusting for baseline FOF (OR: 1.55; 95%CI = 1.19-2.02), and the relationship between baseline frailty status and future FOF also remained significant after adjusting for baseline falls (OR: 1.32; 95%CI = 1.04-1.68). Conclusions Frailty status may predict future falls and FOF among community-dwelling older adults. Strategies to prevent frailty may be beneficial to prevent not only future falls but also future FOF in a community setting. Impact Falls and FOF have a close relationship but a different clinical meaning. Older adults with physical frailty may require monitoring as high-risk not only for falls but also for FOF.

scholarly journals Is there an association between ageist attitudes and frailty?

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Douglas Salguero ◽  
Juliana Ferri-Guerra ◽  
Nadeem Y. Mohammed ◽  
Dhanya Baskaran ◽  
Raquel Aparicio-Ugarriza ◽  
...  
Keyword(s):  
Older Adults ◽  
Logistic Regression ◽  
Multinomial Logistic Regression ◽  
Frailty Index ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Outcome Variable ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Frailty Status

Abstract Background Frailty is defined as a state of vulnerability to stressors that is associated with higher morbidity, mortality and healthcare utilization in older adults. Ageism is “a process of systematic stereotyping and discrimination against people because they are old.” Explicit biases involve deliberate or conscious controls, while implicit bias involve unconscious processes. Multiple studies show that self-directed ageism is a risk factor for increased morbidity and mortality. The purpose of this study was to determine whether explicit ageist attitudes are associated with frailty in Veterans. Methods This is a cross-sectional study of Veterans 50 years and older who completed the Kogan’s Attitudes towards Older People Scale (KAOP) scale to assess explicit ageist attitudes and the Implicit Association Test (IAT) to evaluate implicit ageist attitudes from July 2014 through April 2015. We constructed a frailty index (FI) of 44 variables (demographics, comorbidities, number of medications, laboratory tests, and activities of daily living) that was retrospectively applied to the time of completion of the KAOP and IAT. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by multinomial logistic regression models with frailty status (robust, prefrail and frail) as the outcome variable, and with KAOP and IAT scores as the independent variables. Age, race, ethnicity, median household income and comorbidities were considered as covariates. Results Patients were 89.76% male, 48.03% White, 87.93% non-Hispanic and the mean age was 60.51 (SD = 7.16) years. The proportion of robust, pre-frail and frail patients was 11.02% (n = 42), 59.58% (n = 227) and 29.40% (n = 112) respectively. The KAOP was completed by 381 and the IAT by 339 participants. In multinomial logistic regression, neither explicit ageist attitudes (KAOP scale score) nor implicit ageist attitudes (IAT) were associated with frailty in community dwelling Veterans after adjusting for covariates: OR = .98 (95% CI = .95–1.01), p = .221, and OR:=.97 (95% CI = .37–2.53), p = .950 respectively. Conclusions This study shows that neither explicit nor implicit ageist attitudes were associated with frailty in community dwelling Veterans. Further longitudinal and larger studies with more diverse samples and measured with other ageism scales should evaluate the independent contribution of ageist attitudes to frailty in older adults.

scholarly journals The association between motor capacity and mobility performance: frailty as a moderator

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Carl-Philipp Jansen ◽  
Nima Toosizadeh ◽  
M. Jane Mohler ◽  
Bijan Najafi ◽  
Christopher Wendel ◽  
...  
Keyword(s):  
Older Adults ◽  
Frailty Index ◽  
Community Dwelling ◽  
Daily Routine ◽  
Cross Sectional ◽  
Mobility Performance ◽  
Frailty Status ◽  
Walking Performance ◽  
And Performance ◽  
The Relationship

Abstract Background In older adults, the linkage between laboratory-assessed ‘motor capacity’ and ‘mobility performance’ during daily routine is controversial. Understanding factors moderating this relationship could help developing more valid assessment as well as intervention approaches. We investigated whether the association between capacity and performance becomes evident with transition into frailty, that is, whether frailty status moderates their association. Methods We conducted a cross-sectional analysis of the observational Arizona Frailty Cohort Study (ClinicalTrials.gov identifier: NCT01880229) in a community-dwelling cohort in Tucson, Arizona. Participants were N = 112 older adults aged 65 years or older who were categorized as non-frail (n = 40), pre-frail (n = 53) or frail (n = 19) based on the Fried frailty index. Motor capacity was quantified as normal (NWS) and fast walking speed (FWS). Mobility performance was quantified as 1) cumulated physical activity (PA) time and 2) everyday walking performance (average steps per walking bout; maximal number of steps in one walking bout), measured by a motion sensor over a 48 h period. Hierarchical linear regression analyses were performed to evaluate moderation effects. Results Unlike in non-frail persons, the relationship between motor capacity and mobility performance was evident in pre-frail and frail persons, confirming our hypothesis. A moderating effect of frailty status was found for 1) the relationship between both NWS and FWS and maximal number of steps in one bout and 2) NWS and the average steps per bout. No moderation was found for the association between NWS and FWS with cumulated PA. Conclusion In pre-frail and frail persons, motor capacity is associated with everyday walking performance, indicating that functional capacity seems to better represent mobility performance in this impaired population. The limited relationship found in non-frail persons suggests that other factors account for their mobility performance. Our findings may help to inform tailored assessment approaches and interventions taking into consideration a person’s frailty status.

scholarly journals Frailty and Mortality in a Community-Dwelling Relatively Healthy Older Population

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 573-573
Author(s):  
A R M Saifuddin Ekram ◽  
Joanne Ryan ◽  
Sara Espinoza ◽  
Michael Ernst ◽  
Anne Murray ◽  
...  
Keyword(s):  
Older Adults ◽  
Cox Regression ◽  
Multinomial Logistic Regression ◽  
Frailty Index ◽  
Community Dwelling ◽  
Deficit Accumulation ◽  
Healthy Older Adults ◽  
Frailty Status ◽  
Increased Risk ◽  
Related Mortality

Abstract This study examined factors associated with frailty and studied the association between frailty status and mortality in healthy community-dwelling older persons. Participants included 19,114 individuals from the “ASPirin in Reducing Events in the Elderly” (ASPREE) trial. Frailty was defined using modified Fried phenotype comprising exhaustion, body mass index, grip strength, gait speed and physical activity. A deficit accumulation frailty index (FI) using 66 items was also developed. Correlates of frailty were examined using multinomial logistic regression. The association between frailty status at baseline and mortality was analyzed using Cox regression. At baseline, 39.0% (95% CI: 38.3, 39.7) of participants were prefrail, and 2.2% (95% CI: 2.0, 2.4) were frail according to Fried phenotype, while 40.6% (95% CI: 40.0, 41.3) of participants were pre-frail and 8.1% (95% CI: 7.7, 8.5) were frail according to FI. Older age, female sex, lower education, African-American and Hispanic ethno-racial status, smoking, alcohol use, comorbidities, and polypharmacy were associated with frailty status. Pre-frailty increased risk of all-cause mortality significantly (Fried HR: 1.48; 95% CI: 1.28, 1.71; FI HR: 1.54; 95% CI: 1.31, 1.81); and the risk was even higher for frailty (Fried HR: 2.24; 95% CI: 1.67, 3.00; FI HR: 2.34; 95% CI: 1.83, 2.99) after adjustment for covariates. Cardiovascular disease (CVD) and non-CVD-related mortality showed similar trends. These results highlight a considerable burden of pre-frailty among a large group of community-dwelling, initially healthy older adults. Both Fried phenotype and deficit accumulation FI similarly predicted all-cause, CVD and non-CVD-related mortality in relatively healthy older adults.

scholarly journals TRENDS IN THE PREVALENCE OF FRAILTY IN JAPAN: A META-ANALYSIS FROM THE ILSA-J

2020 ◽  
pp. 1-8
Author(s):  
H. MAKIZAKO ◽  
Y. NISHITA ◽  
S. JEONG ◽  
R. OTSUKA ◽  
H. SHIMADA ◽  
...  
Keyword(s):  
Older Adults ◽  
Weight Loss ◽  
Meta Analysis ◽  
Physical Frailty ◽  
Age And Gender ◽  
Frailty Status ◽  
Japanese Cohort ◽  
And Gender ◽  
Meta Analyses ◽  
Low Activity

Objective: To examine whether age-specific prevalence of frailty in Japan changed between 2012 and 2017. Design: This study performed meta-analyses of data collected from 2012 to 2017 using the Integrated Longitudinal Studies on Aging in Japan (ILSA-J), a collection of representative Japanese cohort studies. Setting: The ILSA-J studies were conducted on community-living older adults. Participants: ILSA-J studies were considered eligible for analysis if they assessed physical frailty status and presence of frailty in the sample. Seven studies were analyzed for 2012 (±1 year; n = 10312) and eight studies were analyzed for 2017 (±1 year; n = 7010). Five studies were analyzed for both 2012 and 2017. Measurements: The study assessed the prevalence of frailty and frailty status according to 5 criteria: slowness, weakness, low activity, exhaustion, and weight loss.Results: The overall prevalence of physical frailty was 7.0% in 2012 and 5.3% in 2017. The prevalence of frailty, especially in people 70 years and older, tended to decrease in 2017 compared to 2012. Slight decreases were found in the prevalence of frailty subitems including weight loss, slowness, exhaustion, and low activity between 2012 and 2017, but change in the prevalence of weakness was weaker than other components. Conclusions: The prevalence of physical frailty decreased from 2012 to 2017. There are age- and gender-related variations in the decrease of each component of frailty.

scholarly journals Association Between Brain β-Amyloid and Frailty in Older Adults

2019 ◽  
Vol 74 (11) ◽  
pp. 1747-1752 ◽  
Author(s):  
Mathieu Maltais ◽  
Philipe De Souto Barreto ◽  
Claudie Hooper ◽  
Pierre Payoux ◽  
Yves Rolland ◽  
...  
Keyword(s):  
Older Adults ◽  
Frailty Index ◽  
Standardized Uptake Value ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Frailty Status ◽  
Positron Emission ◽  
New Information ◽  
Amyloid Aβ ◽  
Β Amyloid

Abstract Background We sought to determine whether cortical and regional β-amyloid (Aβ) were cross-sectionally and prospectively associated with change in frailty status in older adults. Methods We used data from 269 community-dwelling participants from the Multidomain Alzheimer’s Preventive Trial (MAPT) who were assessed for brain Aβ using positron-emission tomography scan. Regional and cortical-to-cerebellar standardized uptake value ratios were obtained. Frailty was assessed by a frailty index composed of 19 items not directly linked to cognition and Alzheimer’s disease. Results A significant and positive cross-sectional and prospective relationship was found for Aβ in the anterior putamen (cross-sectional: β = 0.11 [0.02–0.20], p = .02; prospective: β = 0.11 [0.03–0.19], p = .007), posterior putamen (cross-sectional: β = 0.12 [0.009–0.23], p = .03; prospective: β = 0.11 [0.02–0.21], p = .02), and precuneus regions (cross-sectional: β = 0.07 [0.01–0.12], p = .01; prospective: β = 0.07 [0.01–0.12], p = .01) with increasing frailty. Conclusions This study has found new information regarding cross-sectional and prospective positive associations between region-specific brain Aβ deposits and worsening frailty. The potential mechanisms involved require further investigation.

scholarly journals Toward Using a Smartwatch to Monitor Frailty in a Hospital Setting: Using a Single Wrist-Wearable Sensor to Assess Frailty in Bedbound Inpatients

Gerontology ◽  
2017 ◽  
Vol 64 (4) ◽  
pp. 389-400 ◽  
Author(s):  
Hyoki Lee ◽  
Bellal Joseph ◽  
Ana Enriquez ◽  
Bijan Najafi
Keyword(s):  
Frailty Index ◽  
Hospital Setting ◽  
Area Under The Curve ◽  
Screening Tools ◽  
Recursive Feature Elimination ◽  
Physical Frailty ◽  
Frailty Phenotype ◽  
Frailty Status ◽  
Flexion Extension ◽  
Sensor Configuration

Background: While various objective tools have been validated for assessing physical frailty in the geriatric population, these are often unsuitable for busy clinics and mobility-impaired patients. Recently, we have developed a frailty meter (FM) using two wearable sensors, which allows capturing key frailty phenotypes (weakness, slowness, and exhaustion), by testing 20-s rapid elbow flexion-extension test. Objective: In this study, we proposed an enhanced automated algorithm to identify frailty using a single wrist-worn sensor. Methods: The data collected from 100 geriatric inpatients (age: 78.9 ± 9.1 years, 49% frail) were reanalyzed to validate the new algorithm. The frailty status of the participants was determined using a validated modified frailty index. Different FM phenotypes (31 features) including velocity of elbow rotation, decline in velocity of elbow rotation over 20 s, range of motion, etc. were extracted. A regression model, bootstrap with 2,000 iterations, and recursive feature elimination technique were used for optimizing the FM parameters and identifying frailty using a single wrist-worn sensor. Results: A strong agreement was observed between two-sensor and wrist-worn sensor configuration (r = 0.87, p < 0.001). Results suggest that the wrist-worn FM with no demographic information still yields a high accuracy of 80.0% (95% CI: 79.7-80.3%) and an area under the curve of 87.7% (95% CI: 87.4-87.9%) to identify frailty status. Results are comparable with two-sensor configuration, where the observed accuracy and area under the curve were 80.6% (95% CI: 80.4-80.9%) and 87.4% (95% CI: 87.1-87.6%), respectively. Conclusion: The simplicity of FM may open new avenues to integrate wearable technology and mobile health to capture frailty status in a busy hospital setting. Furthermore, the reduction of needed sensors to a single wrist-worn sensor allows deployment of the proposed algorithm in the form of a smartwatch application. From the application standpoint, the proposed FM is superior to traditional physical frailty-screening tools in which the walking test is a key frailty phenotype, and thus they cannot be used for bedbound patients or in busy clinics where administration of gait test as a part of routine assessment is impractical.

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